From the Editor Neuro-politics: Will you vote with your cortex or limbic system? It’s election season again. Every 4 • Are there reliable neural biomark- years, October becomes the purga- ers of political orientation? • Is political orientation modifiable, Henry A. Nasrallah, MD tory month of politics. But this year, and if so, why are some individuals Editor-in-Chief it’s even more complicated, being jux- ferociously entrenched to one political doi: 10.12788/cp.0046 taposed against a chaotic mosaic of dogma while others are able to untether a viral pandemic, economic travails, themselves and adopt another political social upheaval, and exceptionally doctrine? • What are the brain characteristics toxic political hyperpartisanship. Is voting a purely of “swing voters” who may align them- intellectual decision selves with different parties in different The widespread expectation is that election cycles? (ie, cortical), or is it citizens will vote for their party’s can- • Is there a “religification” of politics driven by visceral didates, but there is now a body of among the ardent fanatics who regard evidence suggesting that our brains the tenets of their political beliefs as emotions (ie, limbic)? may be pre-wired to be liberal or “articles of faith?” conservative. • Is the brain modified by certain Enter neuro-politics. This discipline attributes (such as educational level, is younger than neuro-economics, age, sex, marital status, race, ethnicity, neuro-law, neuro-ethics, neuro-market- and religious affiliation) that translate ing, neuro-art, neuro-culture, or neuro- to political decision-making? esthetics. Neuro-politics focuses on the • Can neuro-politics explain the intersection of politics with neurosci- sprouting of psychiatric symptoms ence.1 However, there are many ante- such as obsessions, anxiety, irritabil- cedents to neuro-politics reflected in ity, anger, hatred, and conspiracy the writings of Plato, Aristotle, Niccolò theories? Machiavelli, John Locke, Baruch • Is political extremism driven by Spinoza, Henri Bergson, William James, cortical structures, limbic structures, or and others. both? Neuro-politics attempts to generate To comment on this data to answer a variety of questions Politics and the brain editorial or other topics about political behavior, such as: Here is a brief review of some studies of interest: henry.nasrallah • Is political orientation associ- that examined the relationship of polit- @currentpsychiatry.com ated with differences in certain brain ical orientation or voting behavior with regions? brain structure and function: Current Psychiatry 14 October 2020 1. Roger Sperry, the 1981 Nobel link between brain structure and psy- Editorial Staff Laureate (for his studies on split-brain chological mechanisms that mediate EDITOR Jeff Bauer 8 patients) reported that in patients who political attitudes. SENIOR EDITOR Sathya Achia Abraham underwent callosotomy, both cerebral 8. To examine the effect of a “first ASSISTANT EDITOR Jason Orszt hemispheres gave the same ratings impression” based on the physical WEB ASSISTANTS of politicians when their photos were appearance of candidates, researchers Tyler Mundhenk, Kathryn Wighton shown to each hemisphere separately.2 compared individuals with damage to Art & Production Staff 2. A functional magnetic resonance the lateral orbitofrontal cortex (OFC) CREATIVE DIRECTOR Louise Koenig imaging (fMRI) study found that the with a group that had frontal dam- ART DIRECTOR Pat Fopma faces of candidates activated partici- age that spared the lateral OFC and DIRECTOR, JOURNAL MANUFACTURING pants’ ventromedial and anterior pre- another group of matched healthy vol- Michael Wendt frontal cortices. Amygdala activation unteers. They used a simulated elec- PRODUCTION MANAGER Donna Pituras was associated with the intensity of the tions paradigm in which participants Publishing Staff emotion.3 voted based solely on photographs of PUBLISHER Sharon Finch 3. A skin conductance study reported the candidates’ faces. Only the group DIRECTOR EBUSINESS DEVELOPMENT that politically liberal individuals had with OFC damage was influenced by Alison Paton low reactivity to sudden noises and attractiveness, while those with an SENIOR DIRECTOR OF SALES threatening stimuli, while conservative intact frontal lobe or non-OFC frontal Tim LaPella counterparts demonstrated high physi- damage relied on other data, such as Editor-in-Chief Emeritus ological reactions to noises and stimuli.4 competence.9 These researchers con- James Randolph Hillard, MD 4. Images of a losing candidate elic- cluded that an intact OFC is necessary ited greater activation on fMRI in the for political decision-making. Frontline Medical Communications insula and ventral anterior cingulate 9. A study using cognitive tasks VP, SALES Mike Guire compared to no activation by exposure reported that liberals are more adept VP, DIGITAL CONTENT & STRATEGY to an image of the winning candidate.5 at dealing with novel information than Amy Pfeiffer 5. Another fMRI study found that conservatives.10 PRESIDENT, CUSTOM SOLUTIONS JoAnn Wahl “individualism” was associated with CIRCULATION DIRECTOR Jared Sonners activation of the medial prefrontal cor- What part of your brain will DIRECTOR, CUSTOM PROGRAMS tex and temporo-parietal junction when you use? Patrick Finnegan participants listened to a set of political Regardless of the data generated by the statements. On the other hand, “con- neuro-politics studies, the bottom line In affiliation with Global Academy for Medical Education, LLC servatism” activated the dorsolateral is: What part of your brain do you use PRESIDENT David J. Small, MBA prefrontal cortex, while “radicalism” when you cast your vote for an issue, a activated the ventral striatum and pos- representative, a senator, or a president? terior cingulate.6 Is it a purely intellectual decision (ie, cor- 6. An EEG activity study of healthy tical), or is it driven by visceral emotions individuals revealed desynchronization (ie, limbic)? Do you believe that every in the alpha band related to the politi- single item in your party’s platform is cians who lost simulated elections and right and virtuous, while every item in 7 Century Drive, Suite 302 Parsippany, NJ 07054 were judged as “less trustworthy” when the other party’s platform is wrong and Tel: (973) 206-3434 the participant watched their faces.7 evil? Can you think of any redeeming Fax: (973) 206-9378 www.frontlinemedcom.com 7. A structural MRI study of young feature of the candidate you hate or the Subscription Inquiries: adults reported that liberalism was party you despise? [email protected] associated with increased gray matter One attribute that we psychia- volume in the anterior cingulate, while trists possess by virtue of our train- conservatism was associated with ing and clinical work is that we are Published through an increased volume of the right amyg- able to transcend dichotomies and to educational partnership with dala. The authors replicated their find- perceive nuances and shades of gray ings and concluded there is a possible about controversial issues. So I hope continued on page 63 Current Psychiatry Vol. 19, No. 10 15 From the Editor From the Editor continued from page 15 we employ the circuits of our brain where References 11 1. Schreiber D. Neuropolitics: twenty years later. Politics Life wisdom putatively resides and which may Sci. 2017;36(2):114-131. develop further (via neuroplasticity) with the 2. Sperry RW, Zaidel E, Zaidel D. Self recognition and conduct of psychotherapy.12 Those brain cir- social awareness in the deconnected minor hemisphere. Neuropsychologia. 1979;17(2):153-166. cuits include: 3. Knutson KM, Wood JN, Spampinato MV, et al. Politics on • prefrontal cortex (for emotional regula- the brain: an FMRI investigation. Soc Neurosci. 2006;1(1): 25-40. tion, decision-making, and value relativism) 4. Oxley DR, Smith KB, Alford JR, et al. Political attitudes • lateral prefrontal cortex (to facilitate vary with physiological traits. Science. 2008;321(5896): 1667-1670. calculated, reason-based decision-making) 5. Spezio ML, Rangel A, Alvarez RM, et al. A neural • medial prefrontal cortex (for emo- basis for the effect of candidate appearance on election outcomes. Soc Cogn Affect Neurosci. 2008;3(4): tional valence and pro-social attitudes and 344-352. behaviors). 6. Zamboni G, Gozzi M, Krueger F, et al. Individualism, conservatism, and radicalism as criteria for processing Election season is However, being human, it is quite likely political beliefs: a parametric fMRI study. Soc Neurosci. that our amygdala may “seep through” and 2009;4(5):367-383. a time to make a 7. Vecchiato G, Toppi J, Cincotti F, et al. Neuropolitics: EEG color our judgment and decisions. But let us spectral maps related to a political vote based on the first positive difference try to cast a vote that is not only good for the impression of the candidate’s face. Conf Proc IEEE Eng Med Biol Soc. 2010;2010:2902-2905. in our patients’ country but also good for our patients, many 8. Kanai R, Feilden T, Firth C, et al. Political orientations are of whom may not even be able to vote. Election correlated with brain structure in young adults. Curr Biol. lives, not just ours 2011;21(8):677-680. season is a time to make a positive difference 9. Xia C, Stolle D, Gidengil E, et al. Lateral orbitofrontal in our patients’ lives, not just ours. Let’s hope cortex links social impressions to political choices. our brains exploit this unique opportunity. J Neurosci. 2015;35(22):8507-8514. 10. Bernabel RT, Oliveira A. Conservatism and liberalism predict performance in two nonideological cognitive tasks. Politics Life Sci. 2017;36(2):49-59. 11. Meeks TW, Jeste DV. Neurobiology of wisdom: a literature overview. Arch Gen Psychiatry. 2009;66(4):355-365. Henry A. Nasrallah, MD 12. Nasrallah HA. Does psychiatric practice make us wiser? Editor-in-Chief Current Psychiatry. 2009;8(10):12,14. Current Psychiatry Vol. 19, No. 10 63.